Idiopathic scoliosis

If your child has been diagnosed with idiopathic scoliosis, we know that you and your family are under stress. So, at Children’s Hospital Boston, we’ll approach your child’s treatment with sensitivity and support—for your child and your whole family.

You can have peace of mind knowing that the team in the Children’s Spinal Program has treated many children with spinal problems—some of which are so rare that few pediatric doctors have come across them—and we can offer you expert diagnosis, treatment and care. Scoliosis is not usually a life-threatening condition, and most children grow up to lead normal, active lives.

About scoliosis

Scoliosis is a condition in which the spine—in addition to the normal front to back curvature—has an abnormal side-to-side “S-” or “C”-shaped curvature. The spine is also rotated or twisted, pulling the ribs along with it to form a multidimensional curve.

The Scoliosis Research Society defines scoliosis as a curvature of the spine measuring 10 degrees or greater on x-ray. The condition isn’t rare. It mainly affects girls—many of whom have mild forms of scoliosis, are never even aware of it, and never need treatment.

Three to five children out of every 1,000 develop spinal curves that are considered large enough to require treatment. Idiopathic scoliosis does tend to run in families, although no one genetic link has been confirmed.

Scoliosis occurs, and is treated, as three main types:

• idiopathic scoliosis: the most common form, with no definite cause, mainly affecting adolescent girls, but existing in three age groups:
  • adolescent idiopathic scoliosis
  • juvenile idiopathic scoliosis
  • infantile (early-onset) idiopathic scoliosis
     
• neuromuscular scoliosis: associated with a neuromuscular condition such as cerebral palsy, myopathy or spina bifida
   
• congenital scoliosis: present at birth, caused by a failure of the vertebrae to form normally—the least common form

About idiopathic scoliosis

“Idiopathic” simply means that there is no definite cause for a given disease or condition. Idiopathic scoliosis isa condition in which the child’s spine—in addition to the normal front to back curvature—has an abnormal side-to-side “S-” or “C”-shaped curvature. The spine is also rotated or twisted, pulling the ribs along with it to form a multidimensional curve.

Idiopathic scoliosis is the most common form of the condition, and it mainly affects adolescent girls.

The Children’s Hospital Boston approach

Children’s Spinal Program is known for clinical innovation, research and leadership. As a world center for the treatment of scoliosis—including a deep experience in treating infantile(early-onset) scoliosis—we’ll provide your child with the most advanced diagnostics and treatments—several of which were developed by our own researchers and clinicians.

One of the first comprehensive programs, Children’s Orthopedic Center is the largest and busiest pediatric orthopedic surgery center in the United States, performing more than 6,000 surgical procedures each year. Our program, ranked among the top three in the country by U.S.News & World Report, is the nation’s preeminent care center for children and young adults with developmental, congenital, neuromuscular and post-traumatic problems of the musculoskeletal system.

Some of our team’s unique accomplishments include our:

• development of the Boston Brace, a custom bracing system widely used throughout the United States and Europe
   
• unique experience in the treatment of adolescent hip conditions
   
• success with the VEPTR^™ (vertical expandable prosthetic titanium rib) procedure: In 1998, Children’s was selected as a site for the first extensive VEPTR use outside San Antonio, where it was developed. Children’s has the second most extensive VEPTR experience in the nation.
   
• experience with, and emphasis on, treating infantile (early-onset) scoliosis
   
• experience with, and research in, brachial plexus birth palsy, including our international, multi-center study of this complex condition
   
• Sports Medicine Program, including its pioneering research into the regeneration of ACL tissue and growth plate-sparing surgeries for ACL repair in pre-adolescents
   
• extensive orthopedic research laboratories
   
• Orthopedic Clinical Effectiveness Research Center for the study of children’s musculoskeletal disorders

We take a team approach to the treatment and care of idiopathic scoliosis:

• A doctor, nurse, orthotist and physical therapist form the care team for most patients.
   
• The team stresses non-surgical techniques whenever possible, with surgery a last resort. We use the safest and most efficacious techniques available.
  • We emphasize orthotic treatment for the effective control of idiopathic scoliosis.
     
• Our team collaborates to tailor our program to the individual needs of each patient:
  • We adjust follow-up intervals and the x-ray needs to a child’s risk of a worsening curve.
     
• When needed, we communicate with other disciplines, such as pulmonology (lungs) and neurology (nervous system).
   
• We provide orthopedic care—including for scoliosis—at Children’s satellite locations, as well as the main campus in Boston.
   
• Infants and young children pose special problems with idiopathic scoliosis:
  • We can often treat babies and children with specially developed non-operative and surgical techniques.
  • Because we’re internationally known as a leading early-onset scoliosis center, our team is regularly consulted by other physicians and families around the globe.

Each year, our Spinal Program caregivers provide comprehensive evaluation, diagnosis, consultation, treatment and follow-up care for children during more than 6,000 outpatient visits. And every year, our orthopedic surgeons perform more than 300 spine procedures on babies, children, adolescents and young adults.

Idiopathic scoliosis: Reviewed by John Emans, MD
© Children’s Hospital Boston, 2010